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Renal > Nephritic Syndrome > Flashcards

Nephritic Syndrome Flashcards

1
Q

What is nephritic syndrome

A

Syndrome fitting the clinical picture of inflammation within the kidney

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2
Q

Defining features of nephritic syndrome

A

Haeamaturia - reflects inflammation of the kidney

Oliguria - due to reduced GFR

Proteinuria - less than 3g/ 24hrs

Hypertension - due to fluid overload

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3
Q

Systemic causes of nephritic syndrome

A

SLE
Post strep GN
Iga nephropathy
good pastures

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4
Q

GS diagnostic test for nephritic syndrome?

A

kidney biopsy

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5
Q

Other investigations for nephritic syndrome

A

Urinalysis - shows haematuria in nephritic syndrome
Bloods- elevated ESR and CRP in inflammation ; may be anaemia

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6
Q

What is an ESR test and what does it do

A

Erythrocyte sedimentantion rate

Test measure how fast/ slow RBC will sink / settle

Inflammation causes RBC to clump together which are heavier to sink faster

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7
Q

What does a CRP test do and show

A

C reactive protein is made in the liver

more is released in response to inflammation

can only diagnose inflammation not the cause of it

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8
Q

Management of nephritic syndrome

A

Blood pressure control- ACE/ ARB, reduces proteinuria and preserves renal function

Corticosteroids- reduce inflammation causing damage to the kidney

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9
Q

What is Iga nephropathy

A

Defined by the presence of mesangial Iga immune deposits

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10
Q

Explain the pathophysiology of Iga nepropathy

A

immune complexes are formed –
become trapped in glomeruli– deposit in mesangial area which normally offers structural support to glomeruli

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11
Q

Key diagnostic factor of Iga nephropathy

A

Haematuria - blood in urine

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12
Q

How are ace inhibitors effective in iga nephropathy

A
  • decrease the pressure of blood entering kidneys
  • decrease inflammatory damage
  • slow progression of the disease
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13
Q

What would immunofluorescence microscopy show for iga neprhopathy

A

Iga complex deposition

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14
Q

What is post streptococcal glomerulonephritis

A

Where the kidneys glomeruli become inflamed after an infection by streptococcal bacteria

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15
Q

When would PSGN usually present

A

1-2 weeks after pharyngitis from group a b haemolytic strep

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16
Q

Diagnosis of PSGN would show ?

A

Light microscope- hypercellular glomeruli

Immunofluorescence shows - starry sky appearance and igg and igm deposits

electron microscope- subendothelial immune complex deposition

17
Q

treatment for PSGN

A
  • Furosemide: for initial treatment of hypertension
  • Antibiotics
18
Q

Pathophsyiology for PSGN

A
  • Group a streptococci carry M protein virulence factor which initiates a type 3 hypersensitivity reaction
  • the immune complex depositions travel to the glomerular basement membrane and deposit
  • the deposit initiates an inflammatory reaction which invovles activation of C3 complement,
19
Q

clinical manifestations for psgn

A

Haematuria
signs of recent infection

20
Q

What occurs in good pastures syndrome

A

ANTI GBM antibodies attack the glomerulus and pulmonary basement membrane

This causes glomerulonephritis and pulmonary haemorrhage

21
Q

Typical presentation of good pastures syndrome

A

acute kidney failure and haemoptysis (coughing of blood)

22
Q

What is the most common cause of primary glomerulonephritis

A

iga nephropathy

23
Q

What is the most common type of glomerulonephritis overall

A

membranous glomerunephritis

24
Q

Key causes for both nephrotic and nephritic syndrome

A

diffuse proliferative GN
membranoproliferative GN

25
Q

What is IgA nephropathy?

A

Deposition of IgA into mesangium of kidney - causes inflammation and damage
Presents asymptomatically with microscopic haematuria
Diagnose by biopsy
Give fish oil and steroids for persisten proteinuria after 3-6 months

26
Q

What is goodpastures disease

A

Goodpasture syndrome is an autoimmune disease that primarily affects the lungs and the kidneys.

Also known as anti-GBM disease and is a rare small-vessel vasculitis.

27
Q

What is post strep glomerulonephritis (cause of glomerulonephritis)

A

Deposition of strep antigens post infection

Presents with haematuria and acute nephritis
Diagnose with eviden of strep infection
Antibiotics and supportive care

28
Q

Henoch choenlein purpura (Cause of glomerulonephritis)

A

Small vessel vasculitis
Affects kidneys and joints due to IgA deposition

29
Q

Triad of symptoms for nephrotic syndrome

A

Hypoalbuniaemia (loss of albumin in urine)
Proteinuria (>3g/24hr)
Oedema - loss of albumin therefore loss of oncotic pressure

30
Q

Causes of nephrotic syndrome

A

Minimal change disease
Focal segmental glomerulosclerosis
Membranous nephropathy c

Renal (15 decks)

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